Toufan Mehrnoush, Ashouri Dina, Hamzehzadeh Sina, Jahromi Behnam Atashi, Chenaghlou Maryam
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Cardiovasc Disord. 2025 May 9;25(1):358. doi: 10.1186/s12872-025-04822-5.
Echocardiography is the standard tool for the evaluation of mitral regurgitation (MR). Although Two-dimensional echocardiography is the most recommended tool, it has some limitations. Three-dimensional echocardiography (3DE) is suggested to overcome these limitations, however, it is more time-consuming. Introducing a simplified and accurate 3-D method could be helpful in this regard.
Patients diagnosed with significant MR who were referred to Shahid Madani heart center, Tabriz, Iran for evaluation of MR severity were entered in this study. Patients with prior MR surgery, poor image quality, and without self-consent for participation in the study were excluded. Two-dimensional transthoracic echocardiography (TTE) and 3D transesophageal echocardiography (TEE) were performed in all patients. MR severity was compared between these two methods and between direct planimetry (DP) of the vena contracta area (VCA) and 3D directed multiplanar reconstruction (MPR).
A total of 53 patients were studied. Thirty-six (69.7%) of the patients were female. The mean age of patients was 66.21 ± 11.91 years. 3DVCA using DP was significantly correlated with the 2D method in terms of MR severity (p = 0.006). There was a significant correlation between the results of 3DE DP and 2DE magnetic resonance voiding cystography (MRVC) diameter (r = 0.503 and p = 0.0001). A significant correlation was also found between the result of DP and MPR-derived VCA using 3D (r = 0.97 and p = 0.0001).
TEE is an invaluable method to decide the severity and mechanism of patients with MR, especially if TTE does not give adequate information. The method proposed in this study for evaluation of MR severity and mechanism using 3D TEE could be a helpful option, especially in the above-mentioned conditions. In this study, 3D direct planimetry had an acceptable correlation with 2DE MRVC and also with 3D MPR-derived VCA.
超声心动图是评估二尖瓣反流（MR）的标准工具。尽管二维超声心动图是最推荐的工具，但它有一些局限性。三维超声心动图（3DE）被认为可以克服这些局限性，然而，它耗时更长。在这方面引入一种简化且准确的三维方法可能会有所帮助。
本研究纳入了被诊断为重度MR并转诊至伊朗大不里士的沙希德·马达尼心脏中心评估MR严重程度的患者。排除既往有MR手术史、图像质量差以及未自愿参与本研究的患者。所有患者均接受二维经胸超声心动图（TTE）和三维经食管超声心动图（TEE）检查。比较这两种方法之间以及二尖瓣反流束缩流颈面积（VCA）的直接平面测量法（DP）与三维定向多平面重建（MPR）之间的MR严重程度。
共研究了53例患者。其中36例（69.7%）为女性。患者的平均年龄为66.21±11.91岁。就MR严重程度而言，使用DP的三维VCA与二维方法显著相关（p = 0.006）。三维DP结果与二维磁共振排尿膀胱造影（MRVC）直径之间存在显著相关性（r = 0.503，p = 0.0001）。使用三维DP与MPR得出的VCA结果之间也发现了显著相关性（r = 0.97，p = 0.0001）。
TEE是确定MR患者严重程度和机制的一种非常有价值的方法，特别是当TTE无法提供足够信息时。本研究中提出的使用三维TEE评估MR严重程度和机制的方法可能是一个有用的选择，尤其是在上述情况下。在本研究中，三维直接平面测量法与二维MRVC以及三维MPR得出的VCA具有可接受的相关性。
